Skin Care Goes With Surgery Plastic Surgeons Turn To Aestheticians

She had just undergone a face-lift to tighten her skin, wrinkled by many years of smoking. The operation went well; the surgeon did a fine job.

But something was wrong. Her skin had not taken on the radiant look she expected. Her face was numb and swollen and the healing was too slow.

In her words: ``I was going to hell.``

Her plastic surgeon had given her post-operative instructions, but Ann did not follow them. She was too afraid to touch anything.

``With all those stitches and staples and wounds, I wanted to avoid all contact with my face,`` she said. ``I left it alone.``

When it became clear that her appearance was not improving, Ann went to see Anne Willis, an aesthetician who works with plastic surgeons to help their patients receive proper skin care before and after operations.

``My job is to ensure that patients use the correct products and methods to cleanse and condition their skin,`` said Willis, who started her career behind a department store cosmetics counter. Now, she runs her own business called Therapeutic Aesthetics.

``Ointments that nourish the skin and facial masks add moisture, eliminate waste and nourish the skin as they sooth.``

Many of the oils and masks are derived from a certain type of seaweed that is freeze-dried soon after harvesting so that it retains its nutritive properties, Willis said.

``Patients have to be extremely careful about what they use on their face following surgery. Some of their oil glands and nerves have been destroyed. They may find their skin is drier or more oily, it may be more sensitive and they may be breaking out with rashes or pimples.``

Several facial cosmetics, formerly thought to help the skin, actually can hurt it.

``Soap and water, alcohol-based products, mineral oil and lanolin can be devastating. They obstruct the pores and delay healing,`` Willis said. She said some patients react to Vitamin E creme and to particular anti-bacterial ointments, as well.

Fortunately, she said, more and more plastic surgeons are becoming aware of the need for skin consultations before and after operations. Her staff also performs facial massages, which help the lymph drain, and that reduces swelling.

``I meet a lot of people who have expensive clothes and jewelry, spend a lot to go to dinner and pay a fortune for plastic surgery,`` Willis said.

``But then, after their surgery, they ask, `Do I need that product?` The cost of facial care preparations is minuscule compared to the surgery. And they are so important to achieve the kind of results a patient expects.``

Willis can help most post-operative patients, but not all of them.

``I had one woman come in here after surgery and her face was one large scab. Her physician thought I would know what to do. I did, but I also knew her situation was too serious for healing oils and cremes alone,`` Willis said.

``She needed a hyperbaric chamber with pure oxygen to promote the healing. I sent her back to her doctor, and he sent her for that care.``

Willis also provides camouflage makeup to hide the scars of plastic surgery, skin cancer operations and injuries and offers consultations in the proper use of that makeup.

``It`s a very traumatic thing to have a defect on your face,`` she said. ``People who meet you can be very cruel, and you can be very hurt by something they say. That`s why camouflage makeup can be so beneficial.``

Willis cautioned, however, about the ingredients of many beauty products. Some cosmetics contain lanolin and mineral oil, which can hurt the skin, she said.

``Also, they contain harmful preservatives to give them a shelf life of seven to 10 years. The products I use have no preservatives.``

Willis has developed enough expertise that she teaches others how to counsel clients about skin problems and skin care. She also sends a newsletter to plastic surgeons to outline a daily skin care program.

``Most plastic surgeons are very aware of skin care needs, but there are still some who don`t pay as much attention to this area as they should,`` she said.

Dr. Sigmund L. Sattenspiel, a fellow of the American Academy of Facial Plastic and Reconstructive Surgery, agreed that it is imporant to counsel patients before and after surgery to ensure they look their best after the operation.

``When people come in for cosmetic surgery, it is because they want to look their best. That includes proper skin care,`` said Sattenspiel, whose office is in Freehold, N.J.

``It is important to use the proper moisturizers and night creams following surgery -- those that are non-allergenic and those that are non-comedogenic, meaning that they don`t block the pores,`` he said.

``Some people just don`t know what is good for them and what is not, and some are afraid to do anything. That`s why they need counseling.``